Research has shown numerous physical abnormalities in people with M.E. including:

• Evidence that the muscles take longer than usual to recover after activity.
• Evidence of lesions in the brain.  S.P.E.C.T. scans (Single Photon Emission Computed Tomography  -  radionuclide scanning) show that there is reduced blood flow to some parts of the brain as well as evidence of central nervous system dysfunction.  These findings differ to those in people with depressive illness.
• Evidence of an over-active immune system.
• Evidence of abnormalities in the endocrine system.
• Evidence of at least 35 abnormal genes (acquired abnormalities, not hereditary), including those that are important in energy production.
• Evidence of problems with the heart and circulation.
• Evidence that symptoms can change from day to day, and even within a day.

A diagnosis of M.E. is not normally considered unless activity levels are reduced by at least 50%.  As there is not yet a test for M.E., it is usually made on the presence of certain symptoms, along with tests to exclude other possibilities, many of which have similar symptoms to M.E. (e.g. glandular fever, M.S., some cancers, other neurological conditions).

It is thought by some doctors that one of the main, underlying problems in M.E. is "metabolic dysfunction" i.e. hypo-thyroidism and hypo-adrenalism, with treatment aiming to remedy these deficiencies. For further details see the "What other help is available?" section and "Your Thyroid and how to keep it healthy", as mentioned in "Further Reading".

The main diagnostic symptoms of M.E. are as follows:

1) Exhaustion and Post-Exertional Malaise  - Exhaustion is a principal symptom of M.E., is experienced by all sufferers, and must not have previously been a problem. It is caused by trivially small exertion - physical or mental - compared to before the onset of the illness. Activity can put someone in bed for days or, if overdone, can cause a major relapse. It produces a post-exertional malaise, accompanied by muscle pain and weakness, that can begin soon after activity or be delayed by as much as 72 hours, which can make planning anything very difficult. The exhaustion in M.E. is severe, disabling, and totally unlike that experienced by healthy people. Some have described it as being totally drained of energy and "having their plug pulled out". Unlike normal tiredness it is not helped by exercise and would be made worse by it.

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